Azure Medical Imaging Server for DICOM Integrating DICOM

Azure Medical Imaging Server for DICOM Integrating DICOM & FHIR through DICOM Cast Moira Dillon modillon@microsoft. com Steven Borg stborg@microsoft. com 02/09/2021

Goals Why DICOM metadata belongs in FHIR Introduce Medical Imaging Server for DICOM & DICOM Cast Demo: Exploring clinical & imaging data Getting started with DICOM Cast Q&A and Discussion

FHIR & DICOM FHIR Clinical data; information centric workflows; whole patient HL 7 – Imaging Integration DICOM Imaging data; imaging-centric workflows; parts of patients DICOM WG-20 – Integration of Imaging and Information Systems

A Small List of Use Cases Add imaging to other hospital systems • https: //dcom. net/studies/{study_id} Add imaging to reports • https: //dcom. net/studies/{study}/series/{series}/instances/{inst}/rendered Support queries that span clinical and imaging data • Patients with mammograms with diagnosed benign lumps Provide feedback to radiologists • Trigger feedback when physician validates/invalidates radiologist determination

Unlocks Researchers: “Give me all the medications prescribed with all the CT Scan documents and their associated radiology reports for any patient older than 45 that has had a diagnosis of osteosarcoma over the last 2 years. ” Unlocks Teleradiologists: “Take parathyroid for example. We do more than any other clinic in the country, and yet I have to beg and plead for surgeons to tell me what they actually found. Out of the more than 500 studies I do each month, I get direct feedback on only three or four. ”

Medical Imaging Server for DICOM Allows standards-based communication with any DICOMweb™ enabled systems Easy deployment in Azure and migration of medical imaging data to the cloud Introduces integration between DICOM imaging metadata with clinical data in FHIR through DICOM Cast

DICOM Cast

FHIR Imaging. Study resource http: //www. hl 7. org/fhir/imagingstudy. html

What’s Next? Structured Reports Secondary Capture DICOM Seg (and related metadata mark-up) Parsing free text radiologist notes into structured FHIR Data And the list goes on …

Demo DICOM Cast “Give me all the medications prescribed with all the CT Scan documents and their associated radiology reports for any patient older than 45 that has had a diagnosis of osteosarcoma over the last 2 years. ” From SIIM Hackathon dataset, we can ask this instead: “Give me all the medications prescribed with all the mammography imaging and their associated diagnostic reports for any patient older than 54 that has had a breast lump over the last 20 years. ” Classified as Microsoft Confidential

Getting started with DICOM Cast Spin up a configured FHIR, DICOM and DICOM Cast environment with defaults in less than 3 minutes. https: //github. com/microsoft/dicomserver/blob/master/docs/quickstarts/d eploy-dicom-cast. md Then push a few medical images to the DICOMweb endpoint.

Questions? Moira Dillon modillon@microsoft. com Program Manager II Classified as Microsoft Confidential Steven Borg stborg@microsoft. com Director of Medical Imaging

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